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very perplexing "lameness" case with no answers
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klwc11
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 Posted: Tue Feb 9th, 2016 11:31 pm
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Several vets have assessed my horse, including specialists, and a ten day stay at a big vet hospital with tons of imaging, labs, lameness evals, etc. No answers although all vets agree something is wrong.

15 yo foundation QH gelding- was my Go-To horse, quiet, willing... I fox hunted him for several seasons. He could lead the field, stay back with the Pony CLubbers, stand patiently with another rider while the rest of the field galloped away- etc. A fantastic horse. Spring 2015- starting to slowly leg him up on my farm after winter off. He began randomly bucking- one buck- then stopping. Perhaps every third or fourth ride--- always about 40 minutes into the school. I had my vet come. No obvious issues. I had my farrier assess his gait/balance in all hooves. Seemed fine. I had a vet chiropractor come- nothing wrong. I changed saddles, then had a saddle fitter come and bought a new saddle, new pad, changed the girth. no dental issues...... As the summer progressed, these random bucking episodes continued- always random but always about 40-50 minutes into a schooling session. Frequently when trotting down a slight grade and to the right. Frequently when landing after jumping a little X or SMALL jump. I started taking the saddle off immediately after a buck, to check the back. I could denote mild tremors on the right side in the loin area. These tremors were mild and went away within a half hour. Had my vet come back. He saw the tremors after I rode the horse for 45 minutes. NOT under the saddle area- but behind. The tremors disappeared after 30 mins or so and the horse was back to normal to back palpation. Vet recommended specialists. Took my horse. Ultrasounds of all limbs, bone scan of entire body, xrays of all limbs, nerve blocks with lameness assessment..... There was some disagreement over possible Right kidney function as the isotope for the bone scan did not metabolize well through the R kidney- so ultra sound of kidneys, scoping the ureters, testing the bladder--- all came out normal. Some vets still questioned if this might be a right kidney issue. Other vets said no- kidney is normal, labs normal.... Horse was discharged without a diagnosis although all vets believe something is causing pain when being ridden at varied gaits at least 40-50 minutes. Tried NSAIDS- did not help. Tried injecting the hocks- moved better but did not stop the buck/tremor. I have had this horse since he was 4 yo Extremely well cared for- no injuries, no history of disease--- nothing. Something is wrong. We don't know what to do next. My horse does not exhibit any of these issues in the pasture. I will say, though, I saw him cross canter in the field the other day, which was odd. He is pretty athletic. Also, I have noted some forging only on the right-- farrier can't see a reason. My horse's timing is off or he wouldn't randomly forge. Never did before. My farrier comes every four weeks.
I have spent about $5000 so far trying to figure out what may be wrong and I am no closer than I was last Spring. Does anyone here have a similar experience? Any ideas? We thought about a trial course of Robaxim, or adequan along with maybe previcox---- but its all just throwing darts at a dart board because we don't know the source of the issue. Several vets are scratching their heads over this one. I am not riding the horse, of course. I don't want to cause him pain and I don't want to get hurt by being thrown. Any helps is appreciated.

Last edited on Tue Feb 9th, 2016 11:32 pm by klwc11

DrDeb
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 Posted: Fri Feb 12th, 2016 02:47 am
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klwc -- The best veterinarian in the world cannot diagnose what does not present itself to him or her. If they can't find a definite locus of redness, swelling, heat or pain, then you cannot expect them to put a name to it.

It sounds to me like your investigations have been very thorough, and though it may not feel like it because you have not received a diagnosis, your money has not been wasted -- you have paid for, and received, a course in sound veterinary procedure and logic. At the same time, I must say that you've covered a field wider than the actual evidence would point to; in other words, injecting the hocks is hardly to be expected to do any good when the only evidence that ever actually presented had to do directly with the horse's back, i.e. the spastic vibration in the long perivertebral muscles which you say your vet also saw after the horse had been ridden for some time. Muscles do this when they are attempting to compensate for the dysfunction of some other bodypart, but generally speaking the dysfunctional bodypart will be closer rather than so far away as the hocks.

Thus I note that the one area that has not been investigated is arthritic changes in your horse's back. I do believe that your saddle change, saddle-fitting, etc. was worthwhile, but it was probably too late if arthritic changes had already occurred in the intervertebral joints. This is one area of the body that is very difficult to image and so you do not report that it has been imaged. But if your old tack had not been fitting right for some time -- and the horse was as broke and good-minded as you say, he may have been tolerating a misfit (with accompanying concentration of pressure) for a long time. Plus, we don't know how well you ride, or whether you sit crookedly, or how 'round' you have your horse go as a general rule -- all of which could also conspire to make a minor saddle misfit into a "gouge" situation that the very broke horse will learn to work around. But in holding himself a certain way in order to avoid the gouge, he also greatly increases his chances of bony changes in the spine.

My suggestion to you is that you scout around for some clinic that will tell you that they can image the intervertebral and costo-vertebral joints from about T14 through L5. You will also want a thorough sacro-iliac workup, with imaging (if possible, which might not be), hand manipulation, and neurological testing. These are the two body areas most likely to be the source of your trouble. Then you'll have to look at their price and the amount of trouble and difficulty and decide whether you want to go to that expense.

Alternatively, you can retire the horse as unrideable. Perhaps there is another job he can do around your place -- a "pasture uncle" who can teach weanlings the laws of life, for example.

You've done an excellent job of training him and caring for him. If you'd like and you have them, you can post some photos of you riding him in your old tack and we can, perhaps, critique that usefully -- so that if you were then making a mistake, you can avoid that with your next/other horses. Please do keep us posted and let me know what you decide about spinal imaging. -- Dr. Deb

 

Jean in Alaska
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 Posted: Fri Feb 12th, 2016 11:28 am
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How about EPSM? Equine Polysaccharide storage myopathy. Dr.Beth A. Valentine, DVM, PhD, is involved with EPSM research and other veterinary matters at the College of Veterinary Medicine, Oregon State University.
There are several articles by Dr. Beth Valentine on the Rural heritage website: https://www.ruralheritage.com/new_rh_website/resources/horse_health/horse_health_main.shtml
Summary of EPSM clinical signs and blood muscle enzyme levels in different horse and pony breeds.
https://www.ruralheritage.com/vet_clinic/epsm_summary.htm

EJacob
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 Posted: Mon Mar 14th, 2016 09:21 am
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Starting back in work after a break; bucking after some work indicating discomfort; discomfort on landing over jump or going down a slight grade; one-sided problem (forging on right); no issues in pasture. These symptoms are compatible with an intermittent, low grade, upward fixation of the patella. Worth checking out anyway,there are some simple lameness tests that can help with clinical diagnosis.

DrDeb
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 Posted: Mon Mar 14th, 2016 09:32 am
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Bucking isn't a usual symptom of locking/sticking stifles (the technical term for this being "upward fixation of the patella" or "intermittent upward fixation of the patella."

Nonetheless a good scan of our many posts on this subject might be worth the horse owner's time. Please use the directions given at the top of the home page of this Forum on how to use the Google Advanced Search function, and then enter keywords "locking stifle", "sticking stifle", "patella", or "stifle". I'd be pleased to hear back from the horse owner as to what her examining veterinarian has said, or what other news about this horse there may be. Cheers -- Dr. Deb


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